Both invasive and minimally invasive procedures carry significant risks of complication, so its important to research physicians and find out whether they are licensed in the surgeries they perform.

Industry observers warn that the past few years have seen a rise of crossover specialists, that is, cosmetology and other hygienic professionals providing various cosmetic services, from Botox to liposuction. Unlicensed technicians are the bane of more qualified plastic surgeons, who say they work hard to retain credentials through the American Society of Plastic Surgeons and regularly have to clean up the botched work of nonprofessionals.

Do your homework, advises Dr. David Kaufman of Folsom-based Kaufman & Clark Plastic Surgery. There are a lot of charlatans out there.

Since the cosmetic market is largely unregulated, Kaufman advises prospective patients check the American Board of Medical Specialties to find out what procedures a surgeon is certified to do and whether they hold a current license with the American Board of Plastic Surgery.

During an initial consultation, patients must remain skeptical, says Dr. Charles Perry of Chrysalis Cosmetics in Sacramento. Ask questions to get a sense of whether the doctor is passionate about his or her work or is simply trying to generate additional revenue.

Its like flying a jet, Perry says. You want someone who has flown combat missions, who probably doesnt have to use any of those skills to take you to Vegas for the weekend. But you want to have that knowledge that if that engine goes out, this guy has flown a plane without an engine.

Meanwhile, the surgeon should interview the patient to ensure that they are not suffering from body dysmorphic disorder, a mental illness associated with obsession over body image. A responsible surgeon will refuse service or require psychological clearance by a mental health professional if they suspect an individual is suffering from a problem that cosmetic surgery cant fix.

Finally, it is appropriate to ask to see before-and-after pictures of former patients with excessive scarring or other complications, in addition to those with perfect results, says Dr. Debra Johnson of Sacramento-based Plastic Surgery Center.

Surgery is serious stuff. Complications can happen, she says. The way people scar is pretty genetic rather than the result of the surgeons technique, so you try to get [a patients] expectations in line with what you think their actual outcome is going to be.